Trish Hyatt – Registration Form

Your Name (required)

Your Email (required)

Clinic or Event (required)

Start Date YYYY-MM-DD (must use dash)

End Date YYYY-MM-DD

YourHome Phone #

Your Cell Phone #

Your Address

Date of Birth YYYY-MM-DD

Gender FemaleMale

Emergency Contact

Contacts #

How did you hear about this event?

Have you attended a Trish Hyatt event before? YesNo

In what capacity? ParticipantSpectator

Please rate your horsemanship abilityBeginnerIntermediateAdvanced

Briefly explain your abilities

Do you train, compete or coach? If so, what level and discipline?

Horse InfoBringing a horseUsing a facility horse

Can your horse be safely ridden in a group?YesNoUnsure

Please tell Trish about the horse you plan to bring and work in this session

Please list your goals or any issues you hope to resolve with your horse or yourself

Additional Info

Payment Amount $

Form will reset after you click send and you should get a copy in your email, if not please email me

Click SEND then Email me for payment directions.

Trish Hyatt
4325 Yellowpoint Rd
Ladysmith, B.C.
V9G1G5